Risk of invasive fungal infections in patients with multiple myeloma receiving novel therapies: a single Asian medical center study

e188 Test. Results: Between August 2013 and February 2015, 22 (15 male, 7 female) out of 422 patients (5.2%) were diagnosed with MGUS. The median age at KTx was 45.1 years (range 22.2-66.0). MGUS was diagnosed at a median 8.0 years (range 1.9-35.3) at a median age of 61.0 years (range 29.6-68.9). The paraprotein(s) was monoclonal in 18 patients (IgM 5.6%, IgM 5.6%, IgG 61.1%, IgG 22.2%, IgA 5.6%) and biclonal in 4 patients (IgM 25%, IgG 25%, IgG 25%, IgA 25%) There was an association between having had at least two KTx and developing MGUS (p1⁄40.09). Similarly, there was a trend toward longer time from first transplant in patients who developed MGUS (8.0 years v 6.4 years; p1⁄40.19). 95.5% of the MGUS patients and 92.5% of the non-MGUS patients were receiving immunosuppression with prednisolone and/or tacrolimus and/or mycophenolate mofetil. There was a significant association between prednisolone use and MGUS development (81.8% v 60.3%; p1⁄40.04) but MGUS was not associated with either tacrolimus or mycophenolate mofetil use. There appeared to be no association between drug combinations and MGUS. None of the patients has progressed to multiple myeloma during the median follow-up period of 0.5 years (range 0.1-1.7). Conclusion: The 5.2% incidence of MGUS after a KTx is considerably higher than the background risk of <0.1%. The use of prednisolone is significant in the development of MGUS. Given the low median age of diagnosis and trend towards having multiple transplants, this suggests a role of long-term immunosuppression on the development of MGUS. Longer follow-up is required to establish the natural history of MGUS in this patient population.